<div class="check">

    <form class="form-horizontal" action="<?= lang_url('generate_payment_link') ?>" method="get" id="generate_link">

        <div class="sec">

            <div id="passenger" class="secp clearfix">

                <h4>Generate link</h4>

                <div class="half pull-left">
                    <div class="inner_prices">

                        <div class="control-group">
                            <label class="control-label">Reservation ID:*</label>

                            <div class="controls">
                                <input type="text" placeholder="Reservation ID" name="reservation_ID" required value="">
                            </div>
                        </div>

                        <div class="control-group">
                            <label class="control-label">Name:*</label>

                            <div class="controls">
                                <input type="text" placeholder="Name" name="name" required value="">
                            </div>
                        </div>

                        <div class="control-group">
                            <label class="control-label">E-mail:*</label>

                            <div class="controls">
                                <input type="email" placeholder="E-mail" name="email" required value="">
                            </div>
                        </div>

                        <div class="control-group">
                            <label class="control-label">Address:*</label>

                            <div class="controls">
                                <input type="text" placeholder="Address" name="address" required value="">
                            </div>
                        </div>

                        <div class="control-group">
                            <label class="control-label">City:*</label>

                            <div class="controls">
                                <input type="text" placeholder="City" name="city" required value="">
                            </div>
                        </div>
                        

                    </div>
                </div>

                <div class="half pull-left">
                    <div class="inner_prices">

                        <div class="control-group">
                            <label class="control-label">Amount:*</label>

                            <div class="controls">
                                <input type="text" placeholder="Amount" name="amount" required  value="">

                            </div>
                        </div>


                        <div class="control-group">
                            <label class="control-label">Surname:*</label>

                            <div class="controls">
                                <input type="text" placeholder="Surname" name="surname" required  value="">

                            </div>
                        </div>

                        <div class="control-group">
                            <label class="control-label">Phone:*</label>

                            <div class="controls">
                                <input type="text" placeholder="Phone" name="phone" required  value="">

                            </div>
                        </div>

                        <div class="control-group">
                            <label class="control-label">ZIP:*</label>

                            <div class="controls">
                                <input type="text" placeholder="ZIP" name="zip" required  value="">

                            </div>
                        </div>
                        
                        <div class="control-group">
                            <label class="control-label">Country:*</label>

                            <div class="controls">
                                
                                <select placeholder="Country" name="country" required>
                                    <?
                                    foreach (config_item('country_list') as $key => $country)
                                    echo "<option value='{$country}'>{$country}</option>";
                                    ?>
                                </select>
                                
                            </div>
                        </div>


                    </div>

                </div>

            </div>
            <!-- /passenger-->

        </div>
        <style>
            #hold_generate_link{
                float: left; width: 615px; margin: 23px 0;
                display: none
            }
            #my_link{width: 603px;}
            #copy{float:right}
        </style>

        <div id="hold_generate_link" class="clearfix">
            <a id="copy" href="javascript:">Copy</a>
            <input id="my_link" type="text">
        </div>

        <div class="hold_booknow">
            <input type="submit" class="booknow" value="Generate link">
        </div>
        <!-- /booknow-->

    </form>

</div>